Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)

Authors: Maria E. Bleil, Glenn I. Roisman, Deven T. Hamilton, Sophia W. Magro, Bradley M. Appelhans, Steven E. Gregorich, Cathryn Booth-LaForce, Robert C. Pianta

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Past research describes robust associations between education and health, yet findings have generally been limited to the examination of education as the number of years of education or educational attainment. Little is known about the specific features or processes underpinning education that are health protective. The objective of the current study was to address this gap by examining specific aspects of early education pertaining to student characteristics and experiences, as well as features of the classroom environment, in predicting cardiometabolic health in adulthood.

Methods

Subjects were 1364 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD, 1991–2009) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE, 2018–2022). Models examined individual education indicators (student social skills, student-teacher relationship quality, and classroom emotional and instructional quality in the period of elementary school and student academic performance between ages 54 months and 15 years) in relation to a composite of cardiometabolic risk in adulthood (ages 26–31), reflecting central adiposity, blood pressure, insulin resistance, inflammation, and dyslipidemia. Models were adjusted for key explanatory factors including socio-demographics, infant characteristics, parental socioeconomic status (SES), and child health status. Follow-up analyses were performed to test potential mediators of early education effects on adult health, including adult SES (educational attainment, household income) and health behaviors (diet quality, activity level, sleep duration, smoking).

Results

In adjusted models, results showed greater student social skills, indexed by a mean of annual teacher ratings between kindergarten and 6th grade, predicted lower cardiometabolic risk in adulthood (β=-0.009, p <.05). In follow-up analyses, results showed the protective effect of student social skills on cardiometabolic risk may be mediated by adult income (β=-0.0014, p <.05) and diet quality (β=-0.0031, p <.05). Effects of the other early education indicators were non-significant (ps > 0.05).

Conclusions

Findings point to the potential significance of early student social competence as a link to long-term health, possibly via the acquisition of resources needed for the maintenance of health, as well as through engagement in health behaviors supporting healthy eating. However, more research is needed to replicate these findings and to elaborate on the role of early student social competence and the pathways explaining its effects on cardiometabolic health in adulthood.
Appendix
Available only for authorised users
Literature
1.
Adler NE, Stewart J. Health disparities across the lifespan: meaning, methods, and mechanisms. Ann N Y Acad Sci. 2010;1186:5–23.CrossRefPubMed
2.
Kawachi I, Adler NE, Dow WH. Money, schooling, and health: mechanisms and causal evidence. Ann N Y Acad Sci. 2010;1186:56–68.CrossRefPubMed
3.
Adler NE, Glymour MM. Why we need to know patients’ education. JAMA Intern Med. 2017;177(8):1172–4.CrossRefPubMed
4.
Zajacova A, Lawrence EM. The relationship between education and health: reducing disparities through a contextual approach. Annu Rev Public Health. 2018;39:273–89.PubMedCentralCrossRefPubMed
5.
Raghupathi V, Raghupathi W. The influence of education on health: an empirical assessment of OECD countries for the period 1995–2015. Arch Public Health. 2020;78:20.PubMedCentralCrossRefPubMed
6.
O’Hearn M, Lauren BN, Wong JB, Kim DD, Mozaffarian D. Trends and disparities in cardiometabolic health among U.S. adults, 1999–2018. J Am Coll Cardiol. 2022;80(2):138–51.PubMedCentralCrossRefPubMed
7.
Cutler DM, Lleras-Muney A, House J, Schoeni R, Kaplan G, Pollack H. 2008, Russell Sage Foundation: New York.
8.
Garrison RJ, Gold RS, Wilson PW, Kannel WB. Educational attainment and coronary heart disease risk: the Framingham offspring study. Prev Med. 1993;22(1):54–64.CrossRefPubMed
9.
Whitaker SM, Bowie JV, McCleary R, Gaskin DJ, LaVeist TA, Thorpe RJ Jr. The association between educational attainment and diabetes among men in the United States. Am J Mens Health. 2014;8(4):349–56.CrossRefPubMed
10.
11.
Dinwiddie GY, Zambrana RE, Doamekpor LA, Lopez L. The impact of educational attainment on observed race/ethnic disparities in inflammatory risk in the 2001–2008 National Health and Nutrition Examination Survey. Int J Environ Res Public Health. 2015;13(1):ijerph13010042.CrossRefPubMed
12.
Kubota Y, Heiss G, MacLehose RF, Roetker NS, Folsom AR. Association of educational attainment with lifetime risk of cardiovascular disease: the atherosclerosis risk in communities Study. JAMA Intern Med. 2017;177(8):1165–72.PubMedCentralCrossRefPubMed
13.
Khan N, Javed Z, Acquah I, et al. Low educational attainment is associated with higher all-cause and cardiovascular mortality in the United States adult population. BMC Public Health. 2023;23(1):900.PubMedCentralCrossRefPubMed
14.
Pappas G, Queen S, Hadden W, Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993;329(2):103–9.CrossRefPubMed
15.
Meara ER, Richards S, Cutler DM. The gap gets bigger: changes in mortality and life expectancy, by education, 1981–2000. Health Aff (Millwood). 2008;27(2):350–60.CrossRefPubMed
16.
Leive AA, Ruhm CJ. Has mortality risen disproportionately for the least educated? J Health Econ. 2021;79:102494.CrossRefPubMed
17.
Miech R, Pampel F, Kim J, Rogers RG. The enduring association between education and mortality: the role of widening and narrowing disparities. Am Sociol Rev. 2011;76(6):913–34.PubMedCentralCrossRefPubMed
18.
Grossman M. Education and Nonmarket Outcomes, in Handbook of the Economics of Education, Hanushek E, Welch F. Editor. 2006, Elsevier: 2006. pp. 577–633.
19.
Emanuel AS, Godinho CA, Steinman C, Updegraff JA. Education differences in cancer fatalism: the role of information-seeking experiences. J Health Psychol. 2018;23(12):1533–44.CrossRefPubMed
20.
Lorini C, Lastrucci V, Paolini D, Bonaccorsi G. Measuring health literacy combining performance-based and self-assessed measures: the roles of age, educational level and financial resources in predicting health literacy skills. A cross-sectional study conducted in Florence (Italy). BMJ Open. 2020;10(10):e035987.PubMedCentralCrossRefPubMed
21.
de Walque D. Education, information and smoking decisions: Evidence from smoking histories, 1940–2000, in Working paper #3362. 2004: Washington.
22.
Pamuk E, Makuc D, Heck K, Reuben C, Lochner K. Socioeconomic status and Health Chartbook. Health, United States, 1998. Hyattsville, Maryland: National Center for Health Statistics; 1998.
23.
Brunello G, Fort M, Schneeweis N, Winter-Ebmer R. The causal effect of education on health: what is the role of health behaviors? Health Econ. 2016;25(3):314–36.CrossRefPubMed
24.
Cutler DM, Lleras-Muney A. Understanding differences in health behaviors by education. J Health Econ. 2010;29(1):1–28.CrossRefPubMed
25.
Berkman LF, Glass T, Berkman LF, Kawachi I. 2000, Oxford University Press: New York. 137–73.
26.
Cowell AJ. The relationship between education and health behavior: some empirical evidence. Health Econ. 2006;15(2):125–46.CrossRefPubMed
27.
Fletcher JM, Frisvold DE. Higher education and health investments: does more schooling affect preventive health care use? J Hum Cap. 2009;3(2):144–76.PubMedCentralCrossRefPubMed
28.
29.
30.
Cochrane SH, Leslie J, O’Hara DJ. Parental education and child health: intracountry evidence. Health Policy Educ. 1982;2(3–4):213–50.CrossRefPubMed
31.
Prickett KC, Augustine JM. Maternal education and investments in children’s health. J Marriage Fam. 2016;78(1):7–25.CrossRefPubMed
32.
Augustine JM, Prickett KC, Kimbro R. Health-related parenting among U.S. families and young children’s physical health. J Marriage Fam. 2017;79(3):816–32.CrossRefPubMed
33.
Sterdt E, Liersch S, Walter U. Correlates of physical activity of children and adolescents: a systematic review of reviews. Health Educ J. 2014;73(1):72–89.CrossRef
34.
Rodenburg G, Oenema A, Kremers SP, van de Mheen D. Parental and child fruit consumption in the context of general parenting, parental education and ethnic background. Appetite. 2012;58(1):364–72.CrossRefPubMed
35.
Hesketh K, Ball K, Crawford D, Campbell K, Salmon J. Mediators of the relationship between maternal education and children’s TV viewing. Am J Prev Med. 2007;33(1):41–7.CrossRefPubMed
36.
Bachman JG, O’Malley PM, Johnston LD, Schulenberg JE, Wallace JM. Racial/ethnic differences in the relationship between parental education and substance use among U.S. 8th-, 10th-, and 12th-grade students: findings from the monitoring the future project. J Stud Alcohol Drugs. 2011;72(2):279–85.PubMedCentralCrossRefPubMed
37.
Fernández-Alvira JM, Te Velde SJ, Singh A, et al. Parental modeling, education and children’s sports and TV time: the ENERGY-project. Prev Med. 2015;70:96–101.CrossRefPubMed
38.
39.
Denham SA. Social-emotional competence as support for school readiness: what is it and how do we assess it? Early Educ Dev. 2006;17(1):57–89.CrossRef
40.
Denham SA, Brown C. Plays Nice with others: social–emotional learning and academic success. Early Educ Dev. 2010;21(5):652–80.CrossRef
41.
Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students’ social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011;82(1):405–32.CrossRefPubMed
42.
Weissberg R, Durlak J, Domitrovich C, Gullotta T, Durlak J. 2015, Guilford Press: New York, NY.
43.
Carter AS, Briggs-Gowan MJ, Davis NO. Assessment of young children’s social-emotional development and psychopathology: recent advances and recommendations for practice. J Child Psychol Psychiatry. 2004;45(1):109–34.CrossRefPubMed
44.
Bornstein MH, Hahn CS, Haynes OM. Social competence, externalizing, and internalizing behavioral adjustment from early childhood through early adolescence: developmental cascades. Dev Psychopathol. 2010;22(4):717–35.PubMedCentralCrossRefPubMed
45.
Cipriano C, Strambler MJ, Naples LH, et al. The state of evidence for social and emotional learning: a contemporary meta-analysis of universal school-based SEL interventions. Child Dev. 2023;94(5):1181–204.CrossRefPubMed
46.
Hamre BK, Pianta RC. Early teacher-child relationships and the trajectory of children’s school outcomes through eighth grade. Child Dev. 2001;72(2):625–38.CrossRefPubMed
47.
Spilt JL, Hughes JN, Wu JY, Kwok OM. Dynamics of teacher-student relationships: stability and change across elementary school and the influence on children’s academic success. Child Dev. 2012;83(4):1180–95.PubMedCentralCrossRefPubMed
48.
Lippard CN, La Paro KM, Rouse HL, Crosby DA. A closer look at teacher–child relationships and classroom emotional context in preschool. Child Youth Care Forum. 2018;47(1):1–21.CrossRef
49.
Ansari A, Hofkens T, Pianta RC. Teacher-student relationships across the first seven years of education and adolescent outcomes. J Appl Dev Psychol. 2020;71:101200.CrossRef
50.
Pianta RC, la Paro KM, Payne C, Cox MJ, Bradley R. The relation of kindergarten classroom environment to teacher, family, and school characteristics and child outcomes. Elementary School J. 2002;102(3):225–38.CrossRef
51.
Mashburn AJ, Pianta RC, Hamre BK, et al. Measures of classroom quality in prekindergarten and children’s development of academic, language, and social skills. Child Dev. 2008;79(3):732–49.CrossRefPubMed
52.
Curby TW, LoCasale-Crouch J, Konold TR, et al. The relations of observed Pre-K Classroom Quality profiles to Children’s achievement and social competence. Early Educ Dev. 2009;20(2):346–72.CrossRef
53.
Guo Y, Connor CM, Yang Y, Roehrig AD, Morrison FJ. The effects of teacher qualification, teacher self-efficacy, and classroom practices on fifth graders’ literacy outcomes. Elementary School J. 2012;113(1):3–24.CrossRef
54.
Bleil ME, Roisman GI, Gregorich SE, et al. Thirty-year follow-up of the NICHD Study of Early Child Care and Youth Development (SECCYD): the challenges and triumphs of conducting in-person research at a distance. BMJ Open. 2023;13(3):e066655.CrossRefPubMed
55.
Network NECCR. Child care and child development: results from the NICHD study of early child care and youth development. Guilford Press; 2005.
56.
Carey WB, McDevitt SC. Revision of the infant temperament questionnaire. Pediatrics. 1978;61(5):735–9.CrossRefPubMed
57.
Bayley N. Bayley Scales of Infant Development: Manual. New York: The Psychological Corporation; 1969.
58.
Gresham FM, Elliott SN. The social skills rating system. Circle Pines, MN: American Guidance Service; 1990.
59.
Woodcock RW, Johnson MB. Woodcock-Johnson Psycho-Educational battery– revised. Allen, TX: DLM; 1989.
60.
Pianta RC. Student Teacher Relationship Scale (STRS): Professional Manual. Psychological Assessment Resources; 2001.
61.
Owen M, Friedman S. The relation of first grade classroom environment to structural classroom features, teacher, and student behaviors. Elementary School J. 2002;102:367–87.CrossRef
62.
Pianta RC, La Paro KM, Hamre BK. Classroom Assessment Scoring System (CLASS) Manual, Pre-K. Paul H. Brookes Pub Co; 2008.
63.
Pianta RC. Developmental science and education: the NICHD Study of Early Child Care and Youth Development findings from elementary school. Advances in child development and behavior. Volume 35. Elsevier Academic; 2007. pp. 253–96.
64.
65.
66.
Chevan A, Sutherland M. Hierarchical partitioning. Am Stat. 1991;45(2):90–6.CrossRef
67.
Hayes AF. Introduction to Mediation, Moderation, and conditional process analysis - Third Edition. A regression-based Approach. Guilford Press; 2022.
68.
Rosseel Y. Lavaan: an R package for structural equation modeling. J Stat Softw. 2012;48(2):1–36.CrossRef
69.
Madley-Dowd P, Hughes R, Tilling K, Heron J. The proportion of missing data should not be used to guide decisions on multiple imputation. J Clin Epidemiol. 2019;110:63–73.PubMedCentralCrossRefPubMed
70.
Rubin D. Multiple imputation for nonresponse in surveys. New York, NY: Wiley; 1987.CrossRef
71.
Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol. 2017;17(1):162.PubMedCentralCrossRefPubMed
72.
Clavel J, Merceron G, Escarguel G. Missing data estimation in morphometrics: how much is too much? Syst Biol. 2014;63(2):203–18.CrossRefPubMed
73.
Mishra S, Khare D. On comparative performance of multiple imputation methods for moderate to large proportions of missing data in clinical trials: a simulation study. J Med Stat Inf. 2014;2(1).
74.
Little R, Rubin D. Statistical analysis with missing data, third edition. 2019: Wiley.
75.
Rubin DB. Multiple imputation after 18 + years. J Am Stat Assoc. 1996;91(434):473–89.CrossRef
76.
Jones DE, Greenberg M, Crowley M. Early social-emotional functioning and public health: the relationship between kindergarten social competence and future wellness. Am J Public Health. 2015;105(11):2283–90.PubMedCentralCrossRefPubMed
77.
Moore S, Daniel M, Paquet C, Dubé L, Gauvin L. Association of individual network social capital with abdominal adiposity, overweight and obesity. J Public Health (Oxf). 2009;31(1):175–83.CrossRefPubMed
78.
Valente TW. Social Networks and Health: models, methods, and applications. New York: Oxford University Press; 2010.CrossRef
79.
Deindl C, Brandt M, Hank K. Social networks, social cohesion, and later-life health. Soc Indic Res. 2016;126:1175–87.CrossRef
80.
81.
Bickel WK, Mellis AM, Snider SE, Athamneh LN, Stein JS, Pope DA. 21st century neurobehavioral theories of decision making in addiction: review and evaluation. Pharmacol Biochem Behav. 2018;164:4–21.CrossRefPubMed
82.
Dohle S, Diel K, Hofmann W. Executive functions and the self-regulation of eating behavior: a review. Appetite. 2018;124:4–9.CrossRefPubMed
83.
Allan JL, McMinn D, Daly M. A bidirectional relationship between executive function and health behavior: evidence, implications, and future directions. Front Neurosci. 2016;10:386.PubMedCentralCrossRefPubMed
84.
Morze J, Danielewicz A, Hoffmann G, Schwingshackl L. Diet quality as assessed by the healthy eating Index, alternate healthy eating Index, Dietary approaches to stop hypertension score, and health outcomes: a second update of a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet. 2020;120(12):1998–e203115.CrossRefPubMed
85.
Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ. 2019;366:l4570.PubMedCentralCrossRefPubMed
86.
Hall PA, Fong GT, Epp LJ, Elias LJ. Executive function moderates the intention-behavior link for physical activity and dietary behavior. Psychol Health. 2008;23(3):309–26.CrossRefPubMed
87.
Perry JL, Carroll ME. The role of impulsive behavior in drug abuse. Psychopharmacology. 2008;200(1):1–26.CrossRefPubMed
88.
Gui Z, Huang S, Chen Y et al. Association between sugar-sweetened beverage consumption and executive function in children. Nutrients. 2021;13(12).
89.
Li S, Guo J, Zheng K, Shi M, Huang T. Is sedentary behavior associated with executive function in children and adolescents? A systematic review. Front Public Health. 2022;10:832845.PubMedCentralCrossRefPubMed
90.
Meijer A, Königs M, de Bruijn AGM, et al. Cardiovascular fitness and executive functioning in primary school-aged children. Dev Sci. 2021;24(2):e13019.CrossRefPubMed
91.
Riggs NR, Spruijt-Metz D, Sakuma KL, Chou CP, Pentz MA. Executive cognitive function and food intake in children. J Nutr Educ Behav. 2010;42(6):398–403.PubMedCentralCrossRefPubMed
92.
Keller KL, Pearce AL, Fuchs B, et al. Children with lower ratings of executive functions have a greater response to the portion size effect. Appetite. 2023;186:106569.CrossRefPubMed
93.
Cunningham SA, Vaquera E, Maturo CC, Narayan KM. Is there evidence that friends influence body weight? A systematic review of empirical research. Soc Sci Med. 2012;75(7):1175–83.PubMedCentralCrossRefPubMed
94.
95.
Bruening M, Eisenberg M, MacLehose R, Nanney MS, Story M, Neumark-Sztainer D. Relationship between adolescents’ and their friends’ eating behaviors: breakfast, fruit, vegetable, whole-grain, and dairy intake. J Acad Nutr Diet. 2012;112(10):1608–13.PubMedCentralCrossRefPubMed
96.
Wang Y, Chen M, Lee JH. Adolescents’ social norms across family, peer, and school settings: linking social norm profiles to adolescent risky health behaviors. J Youth Adolesc. 2019;48(5):935–48.PubMedCentralCrossRefPubMed
97.
Benner AD, Bakhtiari F, Wang Y, Schulenberg J. Party, academic, or prepped for college? School norm profiles and adolescent well-being using national data. J Res Adolesc. 2022;32(4):1388–403.CrossRefPubMed
Metadata
Title
Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)
Authors
Maria E. Bleil
Glenn I. Roisman
Deven T. Hamilton
Sophia W. Magro
Bradley M. Appelhans
Steven E. Gregorich
Cathryn Booth-LaForce
Robert C. Pianta
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18560-4

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue

Research

Associated lifestyle factors of elevated plasma aldosterone concentration in community population, gender-stratified analysis of a cross-sectional survey

Research

Prevention of malaria in pregnancy through health education intervention programs on insecticide-treated nets use: a systematic review

Research

Differentiation of the body build and posture in the population of people with intellectual disabilities and Down Syndrome: a systematic review

Research

Association between socioeconomic status and post-stroke depression in middle-aged and older adults: results from the China health and retirement longitudinal study

Research

Impact of psychosocial work factors on risk of medically certified sick leave due to common mental disorders: a nationwide prospective cohort study of Norwegian home care workers

Research highlight

Research highlight: Impact of COVID-19 Disease Control Committee (CDCC) policies on prevention of the disease using Bayes network inference in west of Iran